John R. Graham is a financial, economic, and policy analyst in the health sector. His appointments include:
Senior Fellow of The National Center for Policy Analysis;
Senior Fellow of The Independent Institute;
Senior Fellow of the Pacific Research Institute;
Senior Fellow of The Fraser Institute;
Adjunct Scholar of The Mackinac Center for Public Policy;
Columnist at Forbes.com's The Apothecary blog;
Member of the Board of Visitors of The Benjamin Rush Society of medical students and physicians.

The Truth Comes Out: Obamacare's Website Enrolled A Grand Total Of Six People On Oct. 1

"Adriana," the woman whose face appeared on the homepage of Obamacare's healthcare.gov, has disappeared from view as the website's problems have grown.

There’s been a lot of spin coming out of the White House regarding the botched launch of Obamacare’s health insurance exchanges. When it was clear that people were having problems with the healthcare.gov website on its launch day, October 1, Health and Human Services Secretary Kathleen Sebelius called it a “great problem to have.” The “glitches” were great, she said, because they were being caused by the overwhelming interest of millions of visitors to the website. But whenever she was asked how many people had actually enrolled in Obamacare insurance, she claimed she “didn’t know.” But now, thanks to a Congressional inquiry, we learn that she did know how many people enrolled on day one of the federal exchange: six.

White House memo: ‘Direct enrollment is still not working’

The House Committee on Oversight and Government Reform, chaired by Rep. Darrell Issa (R., Calif.), obtained three memoranda from the Center for Consumer Information and Insurance Oversight, or CCIIO, which set up the Obama administration’s “war room” on the exchanges’ launch. The first memo, from the morning of October 2, states that “6 enrollments have occurred so far with 5 different issuers.” By the following morning, total enrollments had increased to 248.

This confirms what insurance executives had told me, and others, on the day after the launch of the healthcare.gov website. “Very, very few people that we’re aware of have enrolled in the federal exchange,” one insurance official told the Washington Post. “We are talking single digits.” At the time, it seemed too crazy to be true. But it was true.

“High capacity on the website, direct enrollment not working, VA system not connecting, Experian creating confusion with credit check information” were among the ongoing issues identified on the morning of October 2. A second memo, published that afternoon, stated that “direct enrollment is still not working.” 100 people had successfully enrolled by then, but “some estimates show 40,000 people in the waiting room” trying to sign up.

Some issues won’t be resolved until ‘Year 2’

The October 3 memo released by Rep. Issa states that website problems had left “some service areas with no [insurance plan] rates,” preventing visitors from shopping for coverage. “The consensus of this group is to allow these service areas to be removed in Year 1, and then to tighten the rules and language around this issue in Year 2.”

The memo says that Obamacare “navigators”—people who the government has hired to help people sign up for coverage—“should not be told to use paper applications until there is approval from leadership,” because the paper applications get fed into the website. “Ongoing issues” included “Experian identity-proofing…for consumers,” “eligibility results are breaking intermittently,” and that the “EIDM [Enterprise Identity Management] servers may have software issue.”

Among the biggest problems is that insurers have not been receiving the standard 834 forms that they use to enroll individuals in their health plans. “Issuers not receiving 834s when they should be,” says the October 3 memo.

HHS to issue enrollment data in mid-November

When Kathleen Sebelius testified before Congress this week, she claimed that she had no idea how many people had enrolled onto Obamacare’s exchanges. “We do not have any reliable data around enrollment, which is why we haven’t given it to date,” she claimed under oath. That never made any sense. On this web page, you can view up top the number of people who have viewed this page, down to the individual. All businesses know exactly how many people have consumed their products.

The only reason Sebelius isn’t giving out the number is because it’s embarrassing to the administration. The House Oversight Committee obtained the real numbers by asking the government’s IT contractors to hand them over.

Sebelius did promise to provide enrollment data in “mid-November.” It will be important to sift those numbers for spin. For example: how many people enrolled in Medicaid, the low-quality 1965-era program that doesn’t require a website, vs. the new Obamacare exchanges? How many young vs. old people signed up, and healthy vs. sick?

Obamacare has botched market-based concepts

It’s a scandal that the administration has botched this so thoroughly. But it should be especially worrisome to advocates of market-based health reform. The single-payer portion of Obamacare—expanding Medicaid—is going just fine, at least in the states that have chosen to participate in the expansion. It’s Obamacare’s attempt at leveraging theoretically market-based concepts, in its subsidized private insurance exchanges, that has been so badly bungled.

Republicans should certainly hold Democrats and the Obama administration accountable for what they’ve done. But they should also remember that market-based health reform also relies on using tax credits to help people shop for private insurance products. They explain why Obamacare’s exchanges don’t work—and what they would put in their place—instead of merely calling attention to their failure.

UPDATE: In response to the House Oversight Committee disclosures, HHS spokeswoman Joanne Peters released the following response:

These appear to be notes, they do not include official enrollment statistics. We will release enrollment statistics on a monthly basis after coordinating information from different sources such as paper, on-line, and call centers, verifying with insurers, and collecting data from states. As the Secretary said before Congress, we are focused on providing reliable and accurate information and we do not have that at this time due to the issues with 834 forms. We have always anticipated that the pace of enrollment will increase throughout the enrollment period.

At the daily White House press briefing, Jay Carney called the enrollment data “rough figures.”

Q: Do you know whether the numbers from this war room meeting are accurate, six –

MR. CARNEY: I think I — HHS has put out a statement, and I think it’s been available since yesterday, on that and where they believe it comes from. I think these are rough figures, notes that were sort of a snap in time. I think as the secretary testified in a hearing, a lengthy hearing, the other day, you know, we’re going to assemble accurate data and provide it monthly.

I think that one of the reasons why it’s important to do it on a monthly basis is to make sure that the data is checked and is accurate. Remember it’s coming in from a variety of places, both via the website and via — from states who are running their own exchanges, from applicants who go through mail or go through in-person centers or through the call centers. So, you know, I would refer you to HHS or CMS for more on that.

And I think that the whole point, regardless of how specifically accurate those numbers turn out to be, is that we know and acknowledge that the website has been a problem.

Q: So you don’t think –

MR. CARNEY: And –

Q: Excuse me.

MR. CARNEY: I’m sorry. Go ahead.

Q: You don’t think there’s a transparency problem for the administration when –

MR. CARNEY: I think what Secretary Sebelius has said and I’ve said and others have said is that we will provide enrollment figures on a — on a monthly basis, which is entirely consistent with the kind — with the way that other programs have provided information. And the reason to do that is because we want to make sure it’s accurate. And in this case, because the data is coming in from different places, you need to verify it and make sure that it reflects what’s actually happening. And we will do that.

And look, let me just tell you now, November 1st, we don’t expect those numbers to be very high. And we never did, but they’re going to be even lower because of the challenges we’ve had with the website. You know, I think if Massachusetts is the precedent that makes sense to look at and you look at what happened in the first month of enrollment in Massachusetts in what turned out to be a very successful enrollment period, you’ll see that the first month is going to be slow as people begin to familiarize themselves with the options available to them and then make the choices that they want to make when it comes to their health care.

INVESTORS’ NOTE: The biggest publicly-traded players in Obamacare’s health insurance exchanges are Aetna (NYSE:AET), Humana (NYSE:HUM), Cigna (NYSE:CI), Molina (NYSE:MOH), WellPoint (NYSE:WLP), and Centene (NYSE:CNC), in order of the number of uninsured exchange-eligible Americans for whom their plans are available.

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It’s sure been easy to see how many people have lost their insurance because of Obamacare though, hasn’t it? Face it, it’s not because the website sucks, it’s because Obama sucks and so does everyone that works for him.

Paul, I’ve seen your posts in the past. You and the left wing party embarrass yourselves.

On another note, this article says a total of 6 people signed up day 1. Its not saying its the total that will sign up over the long run, it says on day 1 this was the total. I know you hate facts and can’t understand economics or math, but try to re-read the article and then read what you posted.

You’re absolutely right. This article is a bunch of crap. As a white man, it’s hard for me to believe that this kind of attack is not racially motivated. Sure there are philosophical differences, but the sustained, disrespectful Republican attacks on Obama is more than that…and it stinks.